The BHTA’s position on the abolition of NHS England

Last Updated on 02/04/2025 by Sarah Sarsby

Introduction

On 13 March 2025, Prime Minister, Keir Starmer, announced that NHS England (NHSE) will be formally abolished.

Health and Social Care Secretary, Wes Streeting, confirmed that NHSE will be brought into the Department of Health and Social Care (DHSC) entirely over the next two years.

It is a decision that is supposed to avoid excessive duplication and inefficiencies between NHSE and DHSC. This major reform is also designed to cut bureaucracy, free up capacity, and deliver savings of hundreds of millions of pounds a year, according to the government.

What we currently know

The abolition of NHSE will be phased over the next two years, during which time it will take on a new and more focused role. Under the leadership of the recently announced NHSE executive team, during this transition period, it will:

• Act as a single buyer for life sciences and innovation – streamlining NHS procurement and ensuring faster adoption of new technologies.
• Maximise centralised procurement – cutting inefficiencies in how the NHS buys medicines, devices, and services.
• Support transformation – focusing on innovation and integrating new technologies into the health system.
• Maintain a role in waiting times and financial oversight – though with greater responsibility flowing to local NHS leaders.

The government has made clear that local NHS providers and integrated care systems (ICSs) will have more autonomy, with NHSE stepping back from detailed operational oversight. Waiting time targets and financial frameworks will remain but with greater flexibility for local leaders to decide how to meet them.

Of the combined 17,900 workforce across both NHSE and DHSC, it is expected around 9,000 will go, which means the new and clearly more powerful DHSC team will have around 9,000 staff.

While the political message is clear, the legal process is more complicated. The 2012 Health and Social Care Act legally enshrined NHS England’s independence, meaning that some legislative change will be needed to fully dissolve its infrastructure. However, Wes Streeting has confirmed that much of the change can be delivered without the need for primary legislation, stressing that “time is of a premium” and that the government will “immediately work forward” to begin the transition.

While some aspects of NHSE’s absorption into the DHSC can be enacted through secondary legislation and administrative restructuring, there will still be a need for primary legislative change at some stage. The government is working with the Leader of the House to secure an appropriate timetable, ensuring that the necessary legal adjustments are made without derailing other parliamentary priorities.

What challenges the BHTA foresees from potential procurement changes

It is not yet clear what the procurement landscape will look like with NHSE’s abolishment.

However, NHS Supply Chain, which currently reports to NHSE, is responsible for centralised procurement of products and services into the NHS, which leads to uncertainly around which body will be responsible for procurement going forwards and how centralised procurement may change.

Likewise, it is not yet clear what will happen to the NHS Central Commercial Function (CCF), which owns Sustainability and Social Value, Med Tech Stakeholder Management, and Value-Based Procurement (partially).

For BHTA members, navigating any changes to procurement could be complicated, time-consuming, and challenging. We urge the government to ensure any changes are communicated clearly and with as much time as possible, straightforward, consistent, and as seamless as possible to minimise disruption to vital healthcare services.

BHTA speculation on potential changes to the MedTech Directorate

The MedTech Directorate is set to become more powerful over these next two years, with around 7,000 new staff transitioning in from NHSE. Tasked with building a thriving UK MedTech sector, the body’s remit covers reviewing how medical devices are regulated, commissioned, and used on an ongoing basis.

The current MedTech Directorate Director, David Lawson, who came into post in 2022 will, the BHTA believes, have a much wider portfolio of responsibilities and will need a larger management structure to manage the various pillars of activities. There will now be a direct line from the centre to the ICSs so the pace change will be enhanced and as stated by the Secretary of State, ICSs will have more autonomy.

Any changes to the governance and restructuring of the MedTech Directorate will likely impact BHTA members, who may be subject to new processes. Again, we urge the government to ensure any changes are communicated clearly and with as much time as possible, straightforward, and as seamless as possible to minimise disruption to vital services.

Questions that the government needs to respond to

Off the back of NHS England being abolished, here are the key questions that the BHTA, BHTA members, and the industry more broadly need answers for:

• What will happen to NHS Supply Chain?
• What will become of the NHS Central Commercial Function?
• Who will drive the global medtech agenda – including innovation adoption – going forward? Will it be the DHSC Med Tech Directorate?
• What will become of health and social care integration? Will there be greater responsibility for social care on the part of both integrated care boards (ICBs) [downstream] and DHSC [upstream]?
• Do these NHSE/DHSC changes mean greater power for trust-based procurement organisations? What decisions redound to these non-centralised procurement organisations?
• Are there other health sector quangos that are in the frame for rationalisation similar to NHSE?
• Will the Medicines and MedTech Directorates remain separate? Will there be a new commercial function within the MedTech Directorate with a direct line to the Secretary of State, which would include NHSSC?